www.HIMSSConference.org
#PrecisionHIT
FEBRUARY 11, 2019
ORLANDO, FL
Overcoming Obstacles, Seizing
Opportunities, & Curing Cancer
The Future of Wellness
John D. Halamka MD
International Healthcare Innovation Professor,
Harvard Medical School
The Healthcare Experience Around the World
● Finding the right setting, right provider, and right care in China
● Coordinating care in India
● Exchanging Data in the Nordics
● Seeking Emergency Care in Scotland
● My Healthcare Record in Australia
What is the Urgency to Change?
● Aging societies all over the world - Japan, Sweden, Germany, Italy, US
● Falling birth rates
● Shortage of clinicians
● Unsustainable costs
● Variations in quality
What New Tools are Available in 2019?
● Internet of things and connected health devices are exploding
● Artificial Intelligence and Machine Learning are maintstream tools available
from multiple platform providers
● The era of apps and cloud hosted services has arrived
● Application Programming Interfaces are increasing in number and
sophistication
● Policy drivers including value-based purchasing, promoting interoperability
program and telemedicine friendly reforms
The Connected Home 2019
● Cameras
● Sensors
● Ambient listening/voice control
● Hubs and integration
● APIs
My Experiences with Connected Health Devices
● My own diagnosis and treatment of hypertension
● My wife’s seeking a specialty referral
● My father’s treatment for multiple sclerosis
● My mother’s activities of daily living
● My collaboration with BIDMC@home development
Challenges We Still Face
● Medical/legal precedent with storage, use, and alerts/reminders for patient
generated healthcare data
● Data provenance and quality
● Turning data into information, knowledge and wisdom
● Understanding normal variation
● Security and privacy concerns
How Will Machine Learning Change Healthcare?
● Augmenting, not replacing clinicians
● Helping families/patients/carers navigate the healthcare system
● Examples from South Africa and India
● Buoy Health, Ada and Babylon Health
● A BIDMC Case Study
BIDMC Early Experiences with Machine Learning
● Optimizing the operating room schedule
● Predicting discharge date
● Predicting ambulatory no shows
● Automating fax workflow
● Enhanced search of the health record
Apps/Cloud Hosted Services will Surround the EHR
● Examples from Athena’s More Disruption Please, Epic’s Orchard, and
Cerner’s App Gallery
● Medaware case study and prescription drug monitoring
● Protecting Access to Medicare Act and early experiences with Anvita Health
● Apple’s Healthkit and the consumerization of healthcare
● Suki.ai and reducing clinician burden
The Argonaut Project and the Evolution of APIs
● How it all started
● Year 1
● Year 2
● Year 3 and beyond
● The policy changes needed
The Policy Changes Needed
● The reality of Information Blocking the upcoming rule
● Best practices for use and access to APIs, services and tools
● Reducing clinician burden of documentation
● Rationalizing quality measures
● Encouraging third party innovation
Closing Thoughts
● The future for digital health in 2019 is very
bright
● Although government has a role as convener
and catalyst, the real acceleration will happen
in the private sector and from foundations
● The technology we need is already in place
from the consumer sector, we just need better
integration
● API standards are rapidly maturing
● The urgency to act is clear - we’re all patients,
so let’s make it happen
